Djalma Agripino de Melo Filho

Living conditions and occupational organization associated with common mental disorders

OBJECTIVE To determine the prevalence of common mental disorders (CMD) and evaluate their association with living conditions and occupational organization. METHODS A cross-sectional survey of a random sample of private households was carried out in Olinda, Brazil, in 1993. The sample consisted of 621 adults aged 15 years or over and the participants were interviewed using the Self-Reporting Questionnaire (SRQ-20) and a second questionnaire on social and economic characteristics. Crude and adjusted odds ratios were estimated using logistic regression analysis. RESULTS The overall prevalence of CMD was 35%. Only the variables education level (p<0.0001) and housing conditions (p=0.02) showed an independent association with CMD after adjustment for other living conditions variables, sex, age and marital status. Regarding occupational organization, non-regulated blue-collar workers (OR=2.21; 95% CI 1.1-4.5) and subjects with the lowest per capita monthly household income (OR=2.87; 95%CI 1.4-5.8) showed a higher prevalence of CMD. CONCLUSIONS Lower education level and income, exclusion from the law regulated labor market, and social class structure produce stressful situations increasing CMD.

Condição de vida e mortalidade infantil: diferenciais intra-urbanos no Recife, Pernambuco, Brasil

The objective of this study was to show infant mortality differentials in different areas of Recife, analyzing the relationship between living conditions and mortality risk. An ecological study design compared infant mortality coefficients in 1995 with living conditions indicators obtained from the 1991 National Demographic Census. Information on the 770 infant deaths and 27,965 live births were collected from death and birth certificates. Information on water supply, sanitation, garbage collection, literacy, schooling, income, and overcrowding were used to establish a compound indicator for living conditions, constructed through factor analysis. The neighborhoods were then ordered according to the level of living conditions and grouped in 4 clusters, through hierarchical cluster analysis. Infant, neonatal, and post-neonatal mortality coefficients were 23.94, 17.66, and 6.28, respectively, for cluster I; and 32.04, 20.24, and 11.80 for cluster IV. In general, an inverse relationship was found between infant mortality and living conditions in clusters from Recife, revealing inequalities that are disguised when coefficients are expressed as averages for the entire city.

Physical abuse of older people reported at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil

This cross-sectional study aimed to determine the profile of physical abuse against older people who underwent forensic examination at the Institute of Forensic Medicine in Recife, Pernambuco State, Brazil. The cases, with data from 1,027 forensic reports, were described according to characteristics of the incident, victim, and aggressor. Most cases of violence were produced by mechanical energy, either with blunt objects or by empty-handed attack; the most common day of the week was Sunday, most frequently in the evening, and in the victims home; typical cases involved mild injuries on more than one part of the victims body. The majority of the victims were men, 60 to 69 years of age, brown (mixed-race), married or living with a partner, and retirees/pensioners. The majority of the aggressors were men, known to the victim, and attacking alone. The social transcendence of violence against older people clearly calls for investment in programs to deal with the problem in order to ensure better quality of life for the elderly.

P2-355 Factors associated with overweight and obesity in individuals with HIV/AIDS: a multinomial logistic regression analysis

Introduction The nutritional profile of HIV-infected patients after the introduction of HAART has pointed to high rates of overweight and obesity that have been associated with the emergence of long term co-morbidities, including metabolic changes. Methods A cross-sectional nested case control study was conducted to estimate the prevalence of thinness and overweight/obesity and associated factors in 2018 individuals with HIV/AIDS, using the Body Mass Index (BMI). Thinness were classified as BMI<18.5 kg/m2, overweight/obesity BMI≥25 kg/m2 and eutrophic BMI≥18.5–24.9 kg/m2. As the outcome variable has more than two levels we performed the multinomial logistic regression analyses comparing thinness and overweight/obesity to eutrophic as the reference level. Results The prevalence of thinness was 8.8% and that of overweight/obesity 32.1%. The variables associated with thinness were anaemia and CD4 cell count <200 mm3. The risk factors for overweight/obesity were age ≥40 years and diabetes and the variables identified as protective factors for overweight/obesity were not having a long term partner, smoking, presence of an opportunistic disease, anaemia, and albumin levels <3.5 mg/dl. Conclusion The main nutritional problem observed in this population was overweight and obesity, which were much more prevalent than thinness. Older individuals with diabetes should be targeted for nutritional interventions and lifestyle changes.

Necessidade histórica e ação humana em Morte e vida severina

Using the essential elements oftragic action described in Aristotles Poetics, tbe text compares Joao Cabral de Melo Netos Morte e vida severina to Sopbocles Oedipus rex witb tbepurpose ofbringing to light tbe tension tbat exists between buman necessity and buman action. It is an eminently epidemiologicalfact tbat draws a link between tbese two works. In Morte e vida severina, tbe causa efficiens behind Severinos decision to migrate is afamine; in Oedipus rex, aplagne afflicting tbe inbabitants ofThebes is tbe event tbat hastens discovery ofking Lainss tnie assassin. It is a reflection on tbefinalis and formalis canses behind Severinos and Oedipuss movements and on tbe essential elements oftragic action tbat allows a transitory falsification or, betterput, a rejection oftbe hypotbesis that Morte e vida severina is a tragedy, at least not in Aristotelian terms.